morphine and Hydronephrosis

Enterolithiasis is an uncommon finding of intraluminal calcified meconium. Whereas extraluminal calcifications are commonly reported and usually indicate intrauterine intestinal perforation with intraperitoneal extravasation of meconium (meconium peritonitis), true intraluminal calcifications of meconium in newborns are rare.. We report a case of a newborn boy with pneumothorax and pneumoperitoneum because of a transmediastinal air leakage who unfortunately died on the fifth postnatal day after a pneumopericard. The baby had lung hypoplasia and a hypoplastic thorax. Oligohydramnion was present because of urethral agenesis and anal atresia with rectourinary fistula. Enterolithiasis was found, distributed from the transverse to the rectosigmoid colon. Enterolithiasis was not diagnosed prenatally in this boy, and any of those preexisting pathologies were therefore not assumed before birth except the suspicion for urethral valves because of oligohydramnion.. Approximately 48 cases of human neonatal enterolithiasis have been described in the medical literature. The etiology of enterolithiasis appears to be intraluminal mixture of meconium und alkaline urine--as it appears in anal atresia with enterourinary fistula. Most cases of enterolithiasis are associated with major urogenital and intestinal malformations--especially VACTERL association. With support of modern high-resolution imaging devices, enterolithiasis can be detected antenatally. We suppose that prenatal diagnosis of enterolithiasis is a warning sign of underlying pathologies.

Topics: Abnormalities, Multiple; Colonic Diseases; Critical Illness; Fatal Outcome; Humans; Hydronephrosis; Infant, Newborn; Infant, Premature; Lithiasis; Male; Meconium; Pneumoperitoneum; Pneumothorax; Rectal Fistula; Urinary Fistula

Cloacal malformations are rare anomalies, occurring in females, and in which they demonstrate a single perineal orifice for urethra, vagina, and rectum. Prenatal ultrasonograms (US) of cloacal malformations sometimes show ascites, hydrocolpos, and hydronephrosis. We herein describe the characteristic prenatal US and magnetic resonance imaging (MRI) findings of the cloacal malformations associated with meconium peritonitis.. The pre- and postnatal records of 11 newborn patients with cloacal malformations, treated in our hospital from 1988 to 2004, were reviewed. All fetuses underwent prenatal US by experienced obstetricians, whereas in addition, fetal MRI was performed in 1 patient.. The prenatal US and/or MRI findings showed fetal ascites, a multicystic pelvic mass, oligohydramnios, and bilateral hydronephrosis in 5 of 11 patients with cloacal malformations. In these 5 cases, postnatal examinations showed associated hydrocolpos, hydrometrocolpos, and bilateral hydronephrosis; furthermore, 4 of these 5 cases also showed meconium peritonitis at laparotomy.. The prenatal US and MRI findings, showing fetal ascites, multicystic pelvic mass, bilateral hydronephrosis, and oligohydraminios are highly suggestive of the cloacal malformations associated with meconium peritonitis.

Topics: Abdomen; Abnormalities, Multiple; Cloaca; Esophageal Atresia; Female; Gestational Age; Humans; Hydrocolpos; Hydronephrosis; Infant, Newborn; Magnetic Resonance Imaging; Meconium; Peritonitis; Prenatal Diagnosis; Ultrasonography, Prenatal; Uterus; Vagina

Topics: Abdomen, Acute; Cysts; Diagnosis, Differential; Digestive System Abnormalities; Female; Follow-Up Studies; Hemangioma; Humans; Hydronephrosis; Infant, Newborn; Infant, Newborn, Diseases; Kidney Diseases; Kidney Neoplasms; Liver Neoplasms; Male; Meconium; Neuroblastoma; Ovarian Cysts; Peritonitis; Polycystic Kidney Diseases; Renal Veins; Retroperitoneal Neoplasms; Stomach Neoplasms; Teratoma; Thrombophlebitis; Uterine Diseases; Vaginal Diseases